Adjuvant Arterial Embolization in the Treatment of Benign Primary Bone Tumors in Children

Dick, Harold M.; Bigliani, Louis U.; Michelsen, W J; Johnston, Austin D.; Stinchfield, Frank E.

doi:10.1097/00003086-197903000-00023

Cited by 25 publications

(25 citation statements)

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“…In our study, intraoperative blood loss was 1,614 ml for all patients with spinal OBL and patients with AO suffered much more blood loss than those with CO, which could be attributed to the larger scope and subsequent larger resection range in the treatment of AO. Preoperative embolization has been reported to reduce intraoperative bleeding significantly and can be used as an adjunctive therapy for highly vascular spinal tumors, such as giant cell tumor (GCT) and aneurysmal bone cysts (ABC) [37][38][39]. Although we did not use it in this series, we still consider preoperative embolization a meaningful attempt for spinal OBL, which is a high vascular tumor and often accompanied by a huge amount of intraoperative blood loss.…”

Section: Discussionmentioning

confidence: 94%

Clinical characteristics and treatment options for two types of osteoblastoma in the mobile spine: a retrospective study of 32 cases and outcomes

Yin

Wang

et al. 2013

Eur Spine J

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Purpose A retrospective study of 32 patients with osteoblastoma (OBL) in the mobile spine was performed to analyze the clinical characteristics of two types of spinal OBL. We also aimed to find influential factors for OBL in the mobile spine. Methods Between 2002 and 2011, 32 patients with either conventional osteoblastoma (CO) or aggressive osteoblastoma (AO) in the mobile spine were treated in our center. All patients were treated with either total excision or subtotal excision ? postoperative radiotherapy. The mean follow-up was 45.8 (18-128) months. Clinical data and surgery efficacy were analyzed to search for clinical characteristics of two subtypes of spinal OBL and discuss the possible factors influencing relapse. Results There is significant difference between CO and AO in tumor size (p \ 0.0005), preoperative alkaline phosphatase (ALP, p \ 0.0005) and intraoperative blood loss (p = 0.013). Multivariate logistic regression was used to find the influential factors for relapse and the results were: preoperative ALP, b = 0.023, p = 0.029; surgery protocol, b = -7.597, p = 0.007; tumor size, C3/\3, b = 24.805, p \ 0.0005; age, b = 0.054, p = 0.632; and pathology type, b = 1.998, p = 0.34. Conclusions Tumor size, preoperative ALP and CT images were helpful for distinguishing AO from CO. The difference in intraoperative blood loss between CO and AO is mainly attributed to the size of the lesion. Preoperative ALP, surgery protocol and tumor size (C3/\3) were considered to significantly influence relapse of spinal OBL.

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Section: Discussionmentioning

confidence: 94%

Clinical characteristics and treatment options for two types of osteoblastoma in the mobile spine: a retrospective study of 32 cases and outcomes

Yin

Wang

et al. 2013

Eur Spine J

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“…Preoperative embolization has been reported in the literature to significantly reduce intraoperative blood loss. 25 Meticulous dissection, ensuring that one stays outside the tumor borders, and progressive coagulation are all generally sufficient for limiting intraoperative blood loss.…”

Section: Treatmentmentioning

confidence: 99%

Osteoblastomas of the spine: a comprehensive review

Galgano¹,

Goulart²,

Iwenofu

et al. 2016

FOC

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Osteoblastomas are primary bone tumors with an affinity for the spine. They typically involve the posterior elements, although extension through the pedicles into the vertebral body is not uncommon. Histologically, they are usually indistinguishable from osteoid osteomas. However, there are different variants of osteoblastomas, with the more aggressive type causing more pronounced bone destruction, soft-tissue infiltration, and epidural extension. A bone scan is the most sensitive radiographic examination used to evaluate osteoblastomas. These osseous neoplasms usually present in the 2nd decade of life with dull aching pain, which is difficult to localize. At times, they can present with a painful scoliosis, which usually resolves if the osteoblastoma is resected in a timely fashion. Neurological manifestations such as radiculopathy or myelopathy do occur as well, most commonly when there is mass effect on nerve roots or the spinal cord itself. The mainstay of treatment involves surgical intervention. Curettage has been a surgical option, although marginal excision or wide en bloc resection are preferred options. Adjuvant radiotherapy and chemotherapy are generally not undertaken, although some have advocated their use after less aggressive surgical maneuvers or with residual tumor. In this manuscript, the authors have aimed to systematically review the literature and to put forth an extensive, comprehensive overview of this rare osseous tumor.

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“…This technique has been shown to be an effective treatment, either used alone [2 4, 6, 7, 9, 10, 12-14] or in association with surgery [8,11,12], with a very low incidence of complications [1][2][3][4][5][6][7][8][9][10][11][12][13][14].…”

mentioning

confidence: 99%

Selective arterial embolization in the treatment of aneurysmal bone cyst and angioma of bone

et al. 1992

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Nineteen aneurysmal bone cysts and five angiomas of bone were treated by selective arterial embolization. The median follow-up was 22 months. In 17 patients healing occurred with complete relief of symptoms; in 11 of these almost complete ossification of the lesion resulted. In the remaining cases, little or no ossification was apparent but ossification may take 1 year or more to occur. No recurrence was observed in any of these cases. Recurrence occurred only in two cases. In one, growth of the recurrence stopped after a second embolization, and the X-rays showed no change. Selective arterial embolization represents a treatment of choice in aneurysmal bone cyst and angioma of bone especially of the spine, sacrum, or pelvis. In these sites embolization replaces surgery which might be hazardous due to intraoperative bleeding.

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Adjuvant Arterial Embolization in the Treatment of Benign Primary Bone Tumors in Children

Cited by 25 publications

References 0 publications

Clinical characteristics and treatment options for two types of osteoblastoma in the mobile spine: a retrospective study of 32 cases and outcomes

Clinical characteristics and treatment options for two types of osteoblastoma in the mobile spine: a retrospective study of 32 cases and outcomes

Osteoblastomas of the spine: a comprehensive review

Selective arterial embolization in the treatment of aneurysmal bone cyst and angioma of bone

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